When No News Is Good News: The Surprise Benefits of Knee ArthroscopyIf you have pain in your knee, your doctor may suggest arthroscopy to find the problem. Arthroscopy is a surgical procedure that uses a special TV camera to see inside the joint. Arthroscopy of the knee has been shown to be highly safe and reliable, with few complications. It is also one of the most common orthopedic procedures done today.
About 25 percent of all knee arthroscopies come out "normal," meaning no abnormalities are found. Because of this, some doctors have asked whether arthroscopy may in some cases be unnecessary or overdone. The authors of this study identified 42 patients (44 knees) who had "normal" knee arthroscopies. The authors contacted these patients about three and a half years later, to find out how they were doing.
On average, the patients were 26 years old when they had knee arthroscopy. Three-quarters of them were men. At the time of the procedure, pain was their biggest symptom, followed by knee tenderness. Half of them had a history of knee injury.
A few years after arthroscopy, 64 percent of these patients felt better. Only 2 percent thought they were worse. Sixty-eight percent of patients had less pain, swelling, and knee locking and giving way than they had at the time of the procedure.
What accounts for these improvements? The authors think there could be a placebo effect--a kind of relief that is not due to the specific treatment used. Once patients knew there were no abnormalities, perhaps they simply learned to live with the symptoms. Or there might have been some benefit from the procedure itself.
Some doctors think that MRI scans should be done before knee arthroscopy. An MRI is less invasive and might reduce unnecessary arthroscopies. However, the waiting period for MRIs tends to be longer. And MRIs can be less accurate and more costly. For these reasons, the authors recommend continued use of knee arthroscopy, suggesting that "a negative arthroscopy is not necessarily an adverse result." Even when there are no results, the procedure seems to offer benefits for some patients.
Saqif Hossain, FRCS, and Manthravadi S. Sundar, MCH, FRCS. Negative Knee Arthroscopy: Is It Really Negative? In Arthroscopy. July/August 2001. Vol. 17. No. 6. Pp. 620-623.
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